经胸超声心动图不同切面检测冠状静脉窦血流动力学的对比分析  

Comparative study of two different echocardiography views used to observe the coronary sinus’s hemodynamics

作　　者：郝彩利[1] 贺俊斌 HAO Caili;HE Junbin(Department of Ultrasound,the Third People Hospital of Changzhou,Changzhou 213001,China;Department of Radiology,Wujin People’s Hospital Affiliated to Jiangsu University,Changzhou 213001,China)

机构地区：[1]江苏省常州市第三人民医院超声科,江苏常州213001 [2]江苏大学附属武进医院影像科,江苏常州213001

出　　处：《医学影像学杂志》2024年第1期27-29,共3页Journal of Medical Imaging

摘　　要：目的探讨应用经胸超声心动图获取健康成人冠状静脉窦(coronary sinus,CS)不同切面,检测冠状静脉窦结构和其血流动力学的测量。方法选取42例健康成年人,经胸超声心动图检查获取能观察到CS的不同切面,比较非标准心尖四腔心CS长轴切面、心尖两腔及左心长轴CS短轴切面,胸骨旁右心室流入道及其镜像切面CS开口的获取成功率。选取最佳切面应用二维超声测量CS可见走行长度,应用M型超声测量心动周期内不同时相CS内径及其内径的变化,用脉冲多普勒记录CS血流频谱图。结果42例健康成年人非标准心尖四腔CS长轴切面100%显示,是测量CS可见走行长度及CS内径变化的最佳切面;胸骨旁右心室流入道CS开口切面显示率88.0%。胸骨旁右心室流入道镜像CS开口切面显示率约95.2%,可显示CS开口的形状特点,此切面CS血流方向与声束夹角更小,是测量CS血动力学最佳切面,差异有统计学意义(P<0.05)。脉冲多普勒图表现为收缩期和舒张早期两个正向波和舒张末期一负向波,收缩期峰值流速,舒张早期峰值流速,舒张末期负向峰值各峰值流速均较胸骨旁右心室流入道CS开口切面所测峰值流速高,差异有统计学意义(P<0.05)。结论应用胸骨旁右心室流入道镜像CS开口切面较胸骨旁右心室流入道CS开口切面能更准确的记录CS的血流动力学。经胸超声心动图可以很好的检测健康成年人CS结构及其血流动力学,是临床监测CS理想的首选工具。Objective To explore application of the transthoracic echocardiography to obtain different views of coronary sinus(CS)in healthy adultsand to observe the structure and blood flow dynamics of coronary sinus.Methods 42 healthy adults were randomly selected and examined by transthoracic echocardiography.The long axis view,short axis views and opening views of coronary sinus were displayed in all subjects.The CS display rates of all views were obtained.CS visible running length was measured by two-dimensional echocardiography.The inner diameter and its change in different phases during a cardiac cycle were recorded by M-mode echocardiography.The blood flow dynamics obtained from opening views by pulse wave Doppler.Results Nonstandard apical four chamber view was the best view to display long axis of CS.The display rate of CS in this view was 100%.It could be used to measure the CS visible running length and to record the inner diameter and its change in different phases by M-mode echocardiography.The display rates of opening views in parasternal right ventricular inflow tract and in its mirror section were 88%,95.2%,respectively.The mirror section of parasternal right ventricular inflow tract was better than the parasternal right ventricular inflow tract to record CS flow dynamics because the Doppler angle was smaller in the mirror section(P<0.05).CS’s flow pattern consisted of two positive peak spectrum in a systolic and an early-diastolic phases and an end-diastolic negative flow spectrum.The peak velocities of systole,early-diastole,end-diastole were higher than the peak velocities measured by the view of parasternal right ventricular inflow tract(P<0.05).Conclusion The mirror section of parasternal right ventricular inflow tract is more accurate to be used to measure the blood flow dynamics of CS than the view of parasternal right ventricular inflow tract.Transthoracic echocardiography is an ideal non-invasive tool to observe the structure and blood flow dynamics of coronary sinus clearly.

关 键 词：冠状静脉窦 成年人 超声检查 

分 类 号：R543.3[医药卫生—心血管疾病] R445.1[医药卫生—内科学]